Dentine hypersensitivity and dentine exposure in Arab patient populations

Evaluation of Fluoraphat Pro and VivaSens® In-Office Desensitizing Agents in Controlling Natural Dental Hypersensitivity: A Clinical Study

Introduction Dental erosion from acidogenic diets, vigorous tooth brushing, excessive tooth whitening, gingival recession, periodontal debridement, or surgery may induce dentine hypersensitivity (DH). It manifests as a phenomenon observed in structurally intact teeth devoid of pathological or defective conditions. Hence, this study aimed to evaluate DH risk reduction after using Fluoraphat Pro (Neumunster, Germany) and VivaSens® (Ivoclar Vivadent, Schaan, Liechtenstein, Switzerland) in-office desensitizing agents. Method Twenty-two participants with at least two hypersensitive teeth were randomly selected. Participants were divided into two groups with 22 teeth each, and a desensitizing agent (Fluoraphat Pro and Vivasens) was applied accordingly. Participants were recalled the next day, and a decrease in sensitivity (if any) was evaluated by self-reporting using a 5-point Likert-type scale. Relative Risk (RR) was used to compare the likelihood of sensitivity between two groups and Cohen's d to measure the effect size. A value of p<0.05 was considered significant for all statistical purposes. Result The relative risk (RR) results indicated that Fluoraphat Pro has significantly lower RR than Vivasens for patients with dental sensitivity (RR = 0.350, 95% CI 0.187 - 0.654, z = 3.28, p = 0.001). Fluoraphat Pro was significantly more effective concerning lower sensitivity in teeth located in the upper right (dCohen = 3.217, p = 0.038) and lower right (dCohen = 3.193, p = 0.017) of the mouth than VivaSens®. Conclusion The two commercially available desensitizing agents Fluoraphat Pro and Vivasens tested in this study were effective in controlling DH. Fluoraphat Pro was more efficient in relieving the risk of dental hypersensitivity than VivaSens®. Further research is needed to evaluate the long-term effects of the desensitizing agents and compare DH reduction with other marketed desensitizing products.

The prevalence and predictive factors of dentine hypersensitivity among adults in Turkey

AIM

This study sought to determine the prevalence of dentine hypersensitivity (DH) among adults in Turkey. Also, to ascertain the association between DH and both etiological predictors and demographic patient characteristics.

MATERIAL METHOD

Using a questionnaire and thermal and evaporative tests, 259 women and 209 men in the age range of 18 to 72 were analyzed. Individually, a clinical evaluation of DH signs was conducted. The DMFT index, gingival index, and gingival bleeding were reported for each subject. The gingival recession and tooth wear of sensitive teeth were also evaluated. Pearson Chi-square test was used to compare categorical data. Logistic Regression Analysis was used to examine the risk factors of DH. Data with dependent categorical variables were compared using the McNemar-Browker test. The significance level was p < 0.05.

RESULTS

The average age of the population was 35.6 years. In the present study, a total of 12,048 teeth were analyzed. 1755 had thermal hypersensitivity (14.57%), while 470 experienced evaporative hypersensitivity (3.9%). The incisors were the teeth most impacted by DH, whereas the molars were the least affected. Exposure to cold air and sweet foods, gingival recession, and the presence of noncarious cervical lesions were all strongly linked to DH (Logistic regression analysis, p < 0.05). The cold stimulus increases sensitivity more than the evaporation stimulus.

CONCLUSION

Significant risk factors for both thermal and evaporative DH include cold air, consumption of sweet food, presence of noncarious cervical lesions, and gingival recession. More epidemiological research in this area is still required to fully characterize the risk factors and implement the most effective preventive interventions.

The prevalence, clinical features, and related factors of dentin hypersensitivity in the Turkish population

OBJECTIVES

The purpose of this study was to identify the prevalence and predisposing and etiologic factors of dentin hypersensitivity (DH), as well as the demographic characteristics of patients.

MATERIALS AND METHODS

The 1210 patients were examined. The research was based on a two-step investigation: questionnaire and clinical examination. DH was evaluated by the response of the patient to tactile and air-blast stimuli. Loss of attachment and gingival recession of sensitive teeth was measured on the buccal and lingual surfaces. Also, the tooth wear of sensitive teeth was graded on the buccal and lingual surfaces. Comparisons of nonnormally distributed continuous variables were performed using the Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA) and Dunn's post hoc test. Comparisons of categorical variables were performed using Pearson's chi-square, Fisher's exact chi-square, Yates's chi-square, and the Monte Carlo chi-square test.

RESULTS

One hundred twenty-four patients reported DH, showing a prevalence for self-reported DH of 10.2%. Eight hundred forty teeth were diagnosed as having DH, giving a clinical diagnosis rate of DH of 29.4%. Females (76.8%), the 31-40 years age group (26%), housewives (36.8%), and high school education level (38%) had the highest prevalence of DH as demographic properties. A cold stimulus was the most common stimuli trigger for hypersensitivity (97.1%). Occasional pain (55.5%) showed the highest prevalence in terms of frequency of DH. A higher rate of DH was found with the use of medium brushes (47.4%) and brushing twice per day (59.4%) for 1-2 min (56.2%) with the circular method (33.8%) as oral hygiene habits. The buccal surface of the lower right central incisors (5.7%) had the highest prevalence. The most affected teeth by DH were incisors (38.4%). The buccal surfaces (86.3%) of teeth showed a higher high prevalence of DH compared with the lingual surface (52.7%), similar to gingival recession (40.9% vs. 15.7%) and loss of attachment (68.3% vs. 42.6%).

CONCLUSIONS

Clinically diagnosed DH was more common than self-reported DH. Some factors related to patients such as sex (female), the 31-40 years age group, housewives, high school students, using medium brushes, brushing twice per day, and the circular brushing method were more likely to have a risk for DH. Also, buccal surfaces of teeth, gingival recession, and loss of attachment on the buccal surface of teeth should be considered as predisposing factors for DH.

CLINICAL RELEVANCE

To control and prevent DH, clinicians should consider patients' demographics, predisposing factors, and etiologic factors.

Cross-cultural adaptation of the Arabic version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15)

OBJECTIVES

Many patients who suffer from Dentine Hypersensitivity (DH) often go undiagnosed because they do not consider DH as serious problem that requires treatment. The use of patient reported outcome measures can help in diagnosis and management of DH problems. The aim of the present study was to adapt cross-culturally the original English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Arabic speaking countries.

METHODS

An Arabic version of DHEQ-15 was first developed by forward-backward translation and piloted among a group of dental patients. A cross-sectional study design was then used to test the psychometric properties of the Arabic DHEQ-15 in a wider convenience sample of Libyan dental patients diagnosed with DH. Confirmatory factor analysis was used to test the 3-dimensional distribution of the subscales. The significance level of all statistical tests was set at p≤0.05.

RESULTS

The Arabic DHEQ-15 demonstrated good face and content validity. A total of 462 participants aged on average 39.2 ± 12.9 years took part in the psychometric testing of the Arabic DHEQ-15. The overall Cronbach alpha of the questionnaire was 0.91, and overall Interclass correlation coefficient (ICC) for test-retest repeatability was 0.914. Participants with more severe DH had a significantly higher DHEQ-15 score than those with less severe DH (p<0.001). Those who reported better global rating of their oral health had lower scores on the Arabic DHEQ-15 (p<0.001). Confirmatory factor analysis confirmed 3 subscales of the Arabic DHEQ-15.

CONCLUSIONS

The Arabic DHEQ-15 has been developed and further testing has demonstrated acceptable levels of psychometric properties in an Arabic population. The Arabic DHEQ-15 is a reliable measure of the quality of life impact of DH for use with Arabic speaking populations.

Remineralization of dentin slices using casein phosphopeptide-amorphous calcium phosphate combined with sodium tripolyphosphate

Background

The remineralization approach mechanically occludes the exposed dentinal tubules mechanically, reduces the permeability of dentinal tubules and eliminates the symptoms of dentin hypersensitivity. The aim of the present study was to investigate the remineralization of demineralized dentin slices using CPP–ACP combined with TPP, and the research hypothesis was that CPP–ACP combined with TPP could result in extrafibrillar and intrafibrillar remineralization of dentin.

Methods

Demineralized dentin slices were prepared and randomly divided into the following groups: A (the CPP–ACP group), B (the CPP–ACP + TPP combination group), C (the artificial saliva group), D (the negative control group), and E (the positive control group). Dentin slice samples from groups A, B and C were remineralized and the remineralization effect was evaluated using scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection–Fourier transform infrared spectroscopy (ATR–FTIR) and X-ray diffraction (XRD).

Results

Treatment with CPP–ACP combined with TPP occluded the dentinal tubules and resulted in remineralization of collagen fibrils. The hydroxyapatite crystals formed via remineralization were found to closely resemble the natural dentin components.

Conclusion

CPP–ACP combined with TPP has a good remineralization effect on demineralized dentin slices.